Where can the regulatory vision standards be found?
49 CFR 391.41(b)(10)
A person is physically qualified to drive a commercial motor vehicle (CMV) if that person has distant visual acuity of at least (a)_____ (on Snellen Chart) in each eye without corrective lenses or has distant visual acuity of at least (b)_____ (Snellen) or better in each eye with corrective lenses.
(a) 20/40
(b) 20/40
A person is physically qualified to drive a commercial motor vehicle (CMV) if that person has distant binocular acuity of at least _____ (Snellen) in both eyes together with or without corrective lenses.
20/40
A person is physically qualified to drive a commercial motor vehicle (CMV) if that person has field of vision of at least ___ degrees in the horizontal meridian in each eye.
70
(True or False) A person is physically qualified to drive a commercial motor vehicle (CMV) if that person has the ability to recognize the colors of traffic signals and devices showing standard red, green, and amber.
True
What are required for CMV certification during vision tests?
1. Distant visual acuity
2. Peripheral vision along the horizontal meridian in each eye
3. Color vision
With normal vision, each eye should have _(a)_ degrees of vision along the horizontal meridian _(b) degrees laterally toward the temple and _(c) degrees toward the nose). For both eyes combined, the total horizontal meridian should equal _(d) degrees.
a) 140
b) 90
c) 50
d) 180
(True or False) In macular degeneration, central vision is unaffected while peripheral vision is lost.
FALSE.
Clear central vision is lost while peripheral vision is generally spared.
What visual defects occur with diabetic retinopathy?
Scotomas in central vision (a sequelae to diabetic macular edema), defects in contrast sensitivity and color discrimination.
What eye complication can be caused by sickle cell disease and sickle cell-thalassemia?
Proliferative retinopathy
What is the maximum certification for a driver wearing corrective lenses?
2 years
Note: ME must require driver to wear corrective lenses when operating CMV and advise to carry extra pair.
(T/F) The medical examiner can recertify the driver who qualifies for a federal vision exemption.
FALSE.
The medical examiner must not recertifythe driver who qualifies for a federal vision exemption if certification is contrary to the public interest and presents an unacceptable risk to safety.
(T/F) A driver with monocular vision can apply for a waiver under the federal waiver program as per 49 CFR 391.64.
FALSE.
The vision waiver program is no longer available to applicants; FMCSA has no active waiver program.
What is the recertification period for drivers with monocular vision who were grandfathered into the waiver program (49 CFR 391.64)?
1 year
Certified drivers must first see an ophthalmologist or optometrist for an eye examination, and then see the medical examiner (must provide waiver letter indicating grandfathered status and specialist exam report). The annual medical examination is to make sure that the driver meets the non-visual medical requirements.
What federal act establishes procedures for pilot exemption programs and provides temporary relief for one or more FMCSA regulations?
The Transportation Equity Act of 1998
What are the steps in applying for an initial waiver for monocular vision?
1. Ensure driver meets certification requirements (except monocular vision) as per 49 CFR 391.41.
2. ME completes ME report form and marks the "accompanied by" exemption checkbox and writes "vision" to certificate to identify the type of federal exemption.
3. ME certifies driver for 1 year and gives driver the report and certificate.
4. Driver must send FMCSA the specialist's report along with original ME Report and certificate to receive waiver.
5. Driver must have certificate and waiver when operating CMV.
The vision exemption provides the CMV driver with relief from 49 CFR 391.41(b)(10) for up to ___ year(s), but may be renewed.
2 years
The Federal Vision Exemption Program was established in 1998 and allows some drivers with monocular vision to operate a CMV in interstate commerce.
With medications for age-related macular degeneration, what are the S/E of vascular endothelial growth factor (VEGF) inhibitors that may DQ a driver?
May increase risk of stroke in those with predisposing factors; long-term CV effects not determined.
For the treatment of allergic conjunctivitis, what are the S/E of oral and topical antihistamines that could potentially DQ a driver?
Corneal staining. First generation oral medication may cause drowsiness and fatigue.
For the treatment of allergic conjunctivitis, what are the S/E of mast cell stabilizers that could potentially DQ a driver?
For the treatment of allergic conjunctivitis, what are the S/E of topical non-steroidal anti-inflammatory agents that could potentially DQ a driver?
Transient burning and stinging upon instillation, lacrimation, abnormal vision, acute elevated IOP, corneal changes, superficial punctate keratitis, development of persistent epithelial defects, iritis. Some cause hepatic side effects. General side effects such as chills, facial edema, and fever may also occur
For the treatment of allergic conjunctivitis, what are the S/E of glucocorticoid drops that could potentially DQ a driver?
Cataract formation
Elevated IOP
Glaucoma
Secondary infections
*** Steroids should be used under supervision of an ophthalmologist. Blindness is a risk associated with unsupervised glucocorticoid therapy.
